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March 17, 2008 -- For the second time in a week, researchers are debating
whether all hospital patients should be screened for MRSA.

MRSA (methicillin-resistant Staphylococcus aureus) is on the rise, including
in hospitals.

Last
week, researchers reported that preadmission MRSA tests for some 10,000
surgery patients didn't slow MRSA's spread in a Swiss hospital. That study
appeared in The Journal of the American Medical Association's March 12
edition.

But now, a new study shows a 70%
drop in MRSA's in-hospital spread in three Illinois hospitals that gave MRSA
tests to all patients upon hospital admission. The tests checked for the
presence of MRSA bacteria, even in people with no signs of
MRSA illness.

In the Illinois study -- and in the earlier Swiss study-- preadmission MRSA
tests weren't used to keep anyone out of the hospital. Patients got the
hospital care they needed, regardless of MRSA.

Before giving all patients an MRSA test, the Illinois researchers first gave
MRSA tests only to intensive-care patients. That tactic yielded
"disappointing results," write Evanston Northwestern Health Care's Ari
Robicsek, MD, and colleagues.

But making preadmission MRSA screening standard for all patients -- and
treating and taking precautions with MRSA cases -- cut MRSA's spread to other
hospital patients.

The study is an "important step ... but it is just one step" toward
curbing MRSA in hospitals, writes editorialist Ebbing Lautenbach, MD, MPH,
MSCE, of the University of Pennsylvania's medical school.

"Unfortunately, the one-size-fits-all approach is probably not sensible
for MRSA screening," Lautenbach says. He says that each hospital may need
to design its own MRSA strategy.

Robicsek's study and Lautenbach's editorial appear in the March 18 edition
of the Annals of Internal Medicine.